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Can I deliver vaginally after c-section? Dr. Kaushiki Dwivedee answers your questions

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Many women are candidates for vaginal birth after cesarean (VBAC). Still, the choice to pursue VBAC or schedule a repeat C-section can be difficult.

 

Dr Kaushiki Dwivedee (Head Obstetrics and Gynaecology & Senior Consultant IVF,Artemis Hospital,Gurgaon) shares facts and insight to help you make the decision.

 

What are my chances of giving birth vaginally after having a C-section?

As long as you’re an appropriate candidate for a vaginal birth after a cesarean, also known as a VBAC, there’s a good 60% to 80 % chance you’ll succeed. Of course, your chances of success are higher if the reason for your previous c-section isn’t likely to be an issue this time around.

Why do I hear conflicting information about VBAC vs. repeat C-section?

Today, research continues to make clear the risks and benefits of both VBAC and repeat C-section, and more women are fighting for the chance to make their own choice.

It is important that you procure your information from a well educated doctor who knows the pros and cons of VBAC vs ERCS (elective repeat caesarean) with the theory involved.

Is planning a VBAC or a repeat C-section safer for my baby?

Both have their own merits and de-merits. With VBAC one can avoid another major surgery.But VBAC needs a well trained Obstetric team which can deal with any emergency arising out of the trial of labour specially giving way of the previous caesarean scar while in labour.Incidence of dehiscence (a surgical complication in which a wound ruptures along a surgical incision) of scar is 1 %.

Repeat caesarean means another major surgery but the chance of previous caesarean scar giving way during labour becomes zero.

 

What would make me a good candidate for a VBAC?

If your last caesarean was atleast 18 months back and the indication of caesarean wasn’t a recurrent reason like very small pelvis and history of double layered closure of Lower segment caesarean.

 

What Criteria Must I Meet To Be Considered For VBAC?

As mentioned above, One shouldn’t have had a classical caesarean section with vertical incision on the uterus as well as you should go into labour spontaneously.Inducing artificial labour with previous caesarean section can be dangerous.

 

What factors would make it less likely for me to have a successful VBAC?

A Recurrent reason like small pelvis,big baby,non initiation of spontaneous labour pains.

What are the benefits of having a VBAC?

Avoidance of a major surgery.

What are the risks of attempting a VBAC

Possibility of uterine scar future/dehiscence which can be detrimental to the mother and baby’s health.

 

What kind of interventions will I need if I attempt a VBAC?

So if you decide to try for a vaginal birth after a cesarean, you’ll need continuous monitoring of labour. You’ll also need an IV (which most women in labor have), and you’ll have to refrain from eating anything during labor in case you require an emergency c-section later( If uterine rupture is suspected).

 

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By Dr. Kaushiki Dwivedee

Head-Obstetrics and Gynaecology and Senior Consultant ,Artemis Hospital,Gurgaon

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